Blood substitutes in surgery
Year: 2000
Type: article
Abstract: In the United States, about 12 million units of blood are transfused yearly into about 4 million recipients. Two-thirds of packed red blood cell units are transfused in the perioperative setting. 1 Winslow RM. Hemoglobin-based red cell substitutes. : The Johns Hopkins University Press, Baltimore1992 Google Scholar Some of the limitations to the use of blood include: (1) Blood requires a time-consuming process of type- and cross-matching to minimize the likelihood of transfusion reaction. (2) Packed red blood cells have a limited shelf life and are discarded after 42 days. (3) There is a risk of viral and bacterial transmission with blood transfusion. The risk of HIV transmission is estimated to be 1 in about 1,000,000 units of blood, and the risk of hepatitis C is 1 in about 100,000 units. 2 Goodnough LT Brecher ME Kanter MH AuBauchon JP Transfusion medicine. First of two parts—blood transfusion. N Engl J Med. 1999; 340: 438-447 Crossref PubMed Scopus (819) Google Scholar Approximately 35 patients die each year in the U.S. as a result of major transfusion reactions or bacterial contamination. 1 Winslow RM. Hemoglobin-based red cell substitutes. : The Johns Hopkins University Press, Baltimore1992 Google Scholar (4) The “optimal” hemoglobin in critically ill patients appears to be 7 g/dL in the absence of unstable cardiac disease. 3 Hebert PC Wells G Blajchman MA Marshall J Martin C Pagliarello G et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med. 1999; 340: 409-417 Crossref PubMed Scopus (4097) Google Scholar The reason why transfusion of banked blood is deleterious is unclear, but the age of the transfused blood and the presence of leukocytes may lead to a state of immunosuppression. Thus, the fear of viral transmission and the limitations in the availability of banked blood have lead to an increased interest in the development of alternatives to this precious resource.
Source: Surgery
Author: Stephen M. Cohn
Institution: University of Miami
Language: English
Subfield: Biochemistry
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,130
OpenAlex ID: W2003034022